Rule-Making Notices (Hearing Notices)

Minnesota Administrative Rules state:

2500.0100 Subp.11 Rehabilitative Therapy. “Rehabilitative therapy" means therapy that restores an ill or injured patient to the maximum functional improvement by employing within the practice of chiropractic those methods, procedures, modalities, devices, and measures which include mobilization; thermotherapy; cyrotherapy; hydrotherapy; exercise therapies; nutritional therapy; meridian therapy; vibratory therapy; traction; stretching; bracing and supports; trigger point therapy; massage and the use of forces associated with low voltage myostimulation, high voltage myostimulation, ultraviolet light, diathermy, and ultrasound; and counseling on dietary regimen, sanitary measures, occupational health, lifestyle factors, posture, rest, work, and recreational activities that may enhance or complement the chiropractic adjustment.

2500.4000 Rehabilitative Treatment.

Rehabilitative therapy, within the context of the practice of chiropractic, may be done to prepare a patient for chiropractic adjustment or to complement the chiropractic adjustment, provided the treating chiropractor initiates the development and authorization of the rehabilitative therapy. The administration of the rehabilitative therapy is the responsibility of the treating chiropractor. The rehabilitative therapy must be rendered under the direct supervision of qualified staff.

Iowa:

Iowa Statutes allow chiropractors to provide nutritional advice under Iowa Stats section 151.1 (3) Chiropractic Defined which states:

Persons utilizing differential diagnosis and procedures related thereto, withdrawing or ordering withdrawal of the patient's blood for diagnostic purposes, performing or utilizing routine laboratory tests, performing physical examinations, rendering nutritional advice, utilizing chiropractic physiotherapy procedures, all of which are subject to and authorized by section 151.8.

Iowa Statutes also provide that licensed chiropractors may not administer or prescribe drugs or medicine. Iowa Stats Section 151.5 Operative surgery – drugs.

A license to practice chiropractic shall not authorize the licensee to practice operative surgery, osteopathy, nor administer or prescribe any drug or medicine included in materia medica.

Iowa's administrative rules are silent regarding provision of nutritional advice or counseling as well as the dispensation or prescription of nutritional supplements.

Summary of factual data and analytical methodologies: The Chiropractic Examining Board, in an effort to create an adequate curriculum of 48 hours of board-approved postgraduate study in nutrition, which was called for in the enactment of the statutes under 2005 Wisconsin Act 25, consulted with the following educational bodies and professional associations: Palmer College of Chiropractic; Northwestern Chiropractic College; Wisconsin Chiropractic Association; Wisconsin Dieticians Association.

Analysis and supporting documents used to determine effect on small business or in preparation of economic impact report: The proposed rules for the provisions of nutritional counseling will affect the practice of small business as defined by a company, clinic or chiropractic practice is defined a business with 25 employees or less or less than $5 million in annual receipt (billings).

Chiropractic Small Business Market Analysis: as per the Department of Commerce, the 2002 Economic Census Report for Health professions that are Employers who are chiropractors is:

1. 898 offices of Chiropractic with receipts ($1000s) 255,518 for average receipts of $284,541 per office with 3,477 paid employees (ave. of 4 per office).

as per the Department of Commerce, the 2003 Economic Census Status report for NonEmployers, which are establishments consisting of one licensed Chiropractor engaged in the independent practice of Chiropractic indicates:

1. 303 offices with receipts ($1,000s) of 15,706 for average receipts of $51,835 per office.

The Department of Regulation and Licensing's March of 2006 licensee count indicates that there are 1,708 chiropractors with active licenses (up to date and eligible to practice).

The effect of the rules on the practice of small business may be as follows:

1. Prior to the enactment of the new statutes and the pending proposed rules, licensed chiropractors were able to sell vitamins, herbs or nutritional supplements for the general health and well-being of their patients, however the practice of recommending, counseling or directing patients to take vitamins, herbs or nutritional supplements were prohibited by their scope of practice, and administrative rules governing conduct.

2. The proposed rules will allow chiropractors, who elect to take the prescribed 48 hour program under the rules and pay the $25 fee to the Department of Regulation and Licensing will be able to expand their scope of practice by providing nutritional counseling, guidance and recommendations for vitamins, herbs or nutritional supplements. This is seen as a substantial business benefit through the generation of additional revenues and enhanced patient care.

3. The proposed rules will prohibit chiropractors whom have not taken the prescribed 48-hour program and received their certificate from selling vitamins, herbs or nutritional supplements. This practice is being eliminated as it prevents confusion to the consumer who may have difficulty discerning those chiropractors whom are allowed to provide counseling and guidance in addition to selling, and those chiropractors whom are only allowed to sell vitamins, herbs or nutritional supplements. This is seen by the board as an enhancement to public safety and protection. Chiropractors who are currently selling these products, but wish not to obtain their certificate must discontinue selling these products which will have an effect on their business.

4. The board notes that in addition to the $25 fee, the 48-hour program will have additional fiscal effect of time away from the office and subsequent lost billings, and the program may cost approximately $1,000 or more based on the provider of the program. This cost to small business will be substantially offset and may be entirely eliminated by existing continuing education costs. Chiropractors are required by law to complete 40 hours of continuing education in the biennium. The 48-hour program may be counted toward their ongoing CE requirement in the biennium in which it is completed. This will offset the cost of the program by having it count towards their continuing education requirement, and offsetting additional cost in terms of educational dollars and time away from their practice.

Section 227.137, Stats., requires an “agency" to prepare an economic impact report before submitting the proposed rule-making order to the Wisconsin Legislative Council. The Department of Regulation and Licensing is not included as an “agency" in this section.

Fiscal estimate:

The Department of Regulation and Licensing estimates that this rule will require staff time in the Division of Professional Credentialing, Division of Enforcement, and the Division of Management Services. The total staff salary and fringe is estimated at $13,807.

Anticipated costs incurred by private sector: $25 fee for the certificate, educational costs for the required 48 hour program.

Effect on small business: These proposed rules will have no significant economic impact on small businesses, as defined in s. 227.114 (1), Stats. The Department's Regulatory Review Coordinator may be contacted by email at [e-mail], or by calling [phone].

Agency contact person:

Pamela Haack, Paralegal

Department of Regulation and Licensing

Office of Legal Counsel

1400 East Washington Avenue, Room 152

P.O. Box 8935

Madison, Wisconsin 53708-8935.

Telephone: [phone].

Email: [e-mail].

Place where comments are to be submitted and deadline for submission:

Comments may be submitted to Pamela Haack, Paralegal, Department of Regulation and Licensing, 1400 East Washington Avenue, Room 152, P.O. Box 8935, Madison, Wisconsin 53708-8935, or by email at [e-mail]. Comments must be received on or before July 3, 2006, to be included in the record of rule-making proceedings.

Notice of Hearing

Natural Resources

(Environmental Protection - Water Regulation)

NOTICE IS HEREBY GIVEN that pursuant to ss. 30.12 (1) and (1p), 30.2035, 30.206, 227.11 (2) and 227.24, Stats., interpreting ss. 30.12 (1), (1g), (3) and (3m) and 30.206, Stats., the Department of Natural Resources will hold a public hearing on Natural Resources Board Emergency Order No. WT-24-06(E) pertaining to shore erosion control on rivers and streams. This emergency order took effect on May 8, 2006. This emergency rule creates subch. III to ch. NR 328, Wis. Adm. Code, which establishes two general permits with appropriate conditions and establishes standards for projects that may be authorized under an individual permit. There are no statutory exemptions for the placement of shore erosion control on the banks of rivers and streams.

Standards for general permits and individual permits are based on the science of fluvial geomorphology for determining erosive conditions at a site. Fluvial geomorphology involves studying the influence of flowing surface water on stream channels through the processes of erosion and deposition. This emergency rule establishes general permits for biostabilization and integrated bank protection on waterways less than 35 feet wide and allows placement of these structures in “areas of special natural resource interest".

NOTICE IS HEREBY FURTHER GIVEN that the hearing will be held on:

Tuesday, June 13, 2006 at 3:00 p.m.

Room 413, GEF #2 State Office Building

101 South Webster Street

Madison

NOTICE IS HEREBY FURTHER GIVEN that pursuant to the Americans with Disabilities Act, reasonable accommodations, including the provision of information material in an alternative format, will be provided for qualified individuals with disabilities upon request. Please call Roberta Lund at [phone] with specific information on your request at least 10 days before the date of the scheduled hearing.

Fiscal Effect

According to 2004 data, there were 240 permits processed for shore protection on rivers and streams. Of that amount, 216 required an individual permit at a cost of $300 and 24 were exempt from a permit fee because they were issued to state or federal agencies. Therefore, annual permit revenue under current law is estimated to be $64,800 (216 individual permits x $300).

Under the proposed emergency rule, it is estimated that 180 projects would required a $300 individual permit, 36 projects would be eligible for one of two new $50 general permits, and 24 would continue to be fee-exempt because they would be issued to a state or federal agency. Therefore, annual permit revenue under the proposed rule is estimated to be $55,800 [(180 individual permits x $300) + (36 general permits x $50)]. This will result in a decrease of $9,000 in annual permit revenue.

By converting an estimated 36 individual permits per year to general permits, the proposed emergency rule would streamline the permitting process and thus decrease the amount of workload needed to process permits by 630 hours, or 0.35 FTE, with an associated cost reduction of $20,200 in salary and fringe benefits (630 hours x $32/hour salary and fringe).

The emergency rule be reviewed and comments electronically submitted at the following Internet site: adminrules.wisconsin.gov. Written comments on the proposed rule may be submitted via U.S. mail to Mr. Paul Cunningham, Bureau of Fisheries Management, P.O. Box 7921, Madison, WI 53707. Comments may be submitted until June 23, 2006. Written comments whether submitted electronically or by U.S. mail will have the same weight and effect as oral statements presented at the public hearings. A personal copy of the proposed rule and fiscal estimate may be obtained from Ms. Roberta Lund, Bureau of Watershed Management, P.O. Box 7921, Madison, WI 53707

Notice of Hearings

Natural Resources

(Environmental Protection - Air Pollution Control)

[CR 06-047]

NOTICE IS HEREBY GIVEN that pursuant to ss. 285.11 (1) and (6) and 285.60 (6), Stats., interpreting s. 285.60 (6), Stats., the Department of Natural Resources will hold public hearings on revisions to ss. NR 406.02, 406.04, 407.03 and 410.03, Wis. Adm. Code, relating to air pollution permit exemptions and air pollution permit exemption fees. The State Implementation Plan developed under s. 285.11 (6), Stats., is also revised. In 2003, s. 285.60 (6) (b), Stats., was created as part of 2003 Wisconsin Act 118. This law requires the Department to exempt minor sources from the requirement to obtain air permits if emissions from the source do not present a significant hazards to public health, safety, welfare or to the environment. The Department has examined current permit exemptions in light of this and believes that an expansion of those exemptions is required under the statutes. The proposed rule changes contain the following three elements:

1. Exemption from operation and construction permitting requirements for facilities which have actual emissions of each criteria pollutant (other than lead) of less than 10 tons/year, and which are not subject to additional control requirements such as federal hazardous air pollutant standards.

2. Exemption from construction permitting requirements of any construction/modification type of project at a facility where the project will have actual emissions of criteria pollutants (other than lead) of less than 10 tons/year, and which is not subject to additional control requirements such as federal hazardous air pollutant standards.

3. Add an $800 exemption review fee for all projects which claim exemption under #2.

NOTICE IS HEREBY FURTHER GIVEN that pursuant to s. 227.114, Stats., the proposed rule may have an impact on small businesses. The initial regulatory flexibility analysis is as follows:

a. Types of small businesses affected: Small businesses which have very low emissions or which add additional equipment with very low emissions will be affected. Examples are coating facilities and small printers.

b. Description of reporting and bookkeeping procedures required: The proposed rule change does not create any significant additional reporting or bookkeeping requirements.

c. Description of professional skills required: The proposed rule change does not create an additional need for professional skills.

The Department's Small Business Regulatory Coordinator may be contacted at [e-mail] or by calling [phone].

NOTICE IS HEREBY FURTHER GIVEN that the Department has made a preliminary determination that this action does not involve significant adverse environmental effects and does not need an environmental analysis under ch. NR 150, Wis. Adm. Code. However, based on the comments received, the Department may prepare an environmental analysis before proceeding with the proposal. This environmental review document would summarize the Department's consideration of the impacts of the proposal and reasonable alternatives.

NOTICE IS HEREBY FURTHER GIVEN that pursuant to the Americans with Disabilities Act, reasonable accommodations, including the provision of information material in an alternative format, will be provided for qualified individuals with disabilities upon request. Please call Robert Eckdale at [phone] with specific information on your request at least 10 days before the date of the scheduled hearing.

NOTICE IS HEREBY FURTHER GIVEN that the hearings will be held on:

Tuesday, June 27, 2006 at 1:00 p.m.

Prairie Room (lower level), Charles M. White Public Library, 1001 Main Street,

Stevens Point

Wednesday, June 28, 2006 at 1:00 p.m.

Room GO9, GEF #2 State Office Building

101 South Webster Street

Madison

Thursday, June 29, 2006 at 1:00 p.m.

Room 141, DNR Southeast Region Hdqrs.

2300 N. Dr. Martin Luther King Jr. Dr.

Milwaukee

Fiscal Estimate

The construction permit exemption is estimated to allow for 40 projects per year that currently require a construction permit to be exempt from that requirement. However, these projects will still require the department to issue an operation permit or to revise an existing operation permit. Based on an estimated loss of 40 construction permits per year, and an average cost per construction permit of $6,000, the revenue loss would be $240,000/year. With the proposed $800 exemption fee, the gain in fees would be $32,000/year (40 exemptions at $800 per exemption) for a net loss of funds of $208,000/year.

Any reduced workload from permit writing will likely be shifed to ensuring the exempted sources are in compliance with air requirements.

The proposed rule and fiscal estimate may be reviewed and comments electronically submitted at the following Internet site: adminrules.wisconsin.gov. Written comments on the proposed rule may be submitted via U.S. mail to Mr. Steve Dunn, Bureau of Air Management, P.O. Box 7921, Madison, WI 53707. Comments may be submitted until June 30, 2006. Written comments whether submitted electronically or by U.S. mail will have the same weight and effect as oral statements presented at the public hearings. A personal copy of the proposed rule and fiscal estimate may be obtained from Robert Eckdale, Bureau of Air Management, P.O. Box 7921, Madison, WI 53707.